Laparoscopic staging in carcinoma stomach and its impact on treatment plan

Ashish Sam, Samuel (2014) Laparoscopic staging in carcinoma stomach and its impact on treatment plan. Masters thesis, Christian Medical College, Vellore.


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OBJECTIVE: Primary Objectives: 1. To study the efficacy of staging laparoscopy as compared to Computerized Tomography in assessingmetastatic disease (peritoneal and liver surface), T3 and T4 disease and location of primary tumor. 2. To study the role of staging laparoscopy in altering the management plan. Secondary Objective: 1. To look at the role of peritoneal cytology. METHODS: This is a prospective study done among 66 consecutive patients diagnosed with adenocarcinoma stomach. Findings of both investigations were compared with final histopathology report. Peritoneal fluid aspiration cytology was done in all patients. RESULTS: Of the 66 patients staging laparoscopy (SL) detected 23 patients with peritoneal metastases as against none by computed tomography (CT). SL detected 10 patients with ascites and 5 with liver surface metastases as against 6 patients with ascites and none with liver metastases by CT. There was a change in plan in 30 patients out of 66 patients recruited for the study (46%) based SL findings. T- Stage on staging laparoscopy shows fair agreement with gold (k=0.34, p=0.0004) so also the site of tumor was in agreement. Peritoneal fluid was positive in 7.58% by using the routine Papanicolaou staining.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Staging Laparoscopy ; Peritoneal fluid Cytology ; Computed tomography ; Peritoneal disease-P1, P2, P3, T3 and T4 disease ; Liver Surface metastsis.
Subjects: MEDICAL > General Surgery
Depositing User: Devi S
Date Deposited: 24 Jun 2018 18:42
Last Modified: 24 Jun 2018 18:42

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